Tooth discoloration (also termed dye staining ) is an abnormal tooth color, color or translucency. The external color change is the accumulation of stains on the tooth surface. The internal color change is caused by the absorption of pigment particles into the tooth structure. Sometimes there are several different coexistence factors that are responsible for discoloration.
Video Tooth discoloration
Normal tooth color
Dental appearance and perception are the result of complex interactions of factors such as lighting conditions, translucency, opacity, light scattering, luster and human eyes and brain. Of this amount, intrinsic tooth pigmentation is the most influential, which in turn is determined by genetic and natural factors. Light that affects the teeth undergoes reflection, absorption, and transmission at various levels in each layer of tissue from the substance of the tooth. The reflected light that is detected by the human eye determines the perceived appearance of the tooth.
Teeth have a thin enamel layer on the outer surface. The enamel enamel is whiter and semitransparent, and donates a blue, pink green color to the color of the tooth. The underlying dentine layer is darker than the enamel, brownish yellow, and less transparent. Dentine forms most of the tooth substance, and contributes most to the overall color of the tooth. The core of the tooth is a soft connective tissue called the dental pulp. Pulp is pink/red due to vascularization, but rarely seen through enamel and dentine above it unless the thickness of this layer is reduced by the teeth (or rarely internal resorption).
Public opinion about the color of normal teeth tends to be distorted. Commonly reinforced cosmetic dental images in the media. In one report, the most common dental color in the general population ranged from A1 to A3 in the classic VITA A1-D4 shading guide.
Dental colors vary according to race, gender and geographic area. Women generally have slightly whiter teeth than men, partly because women's teeth are smaller, and therefore there is less dentine, partly seen through the enamel layer. For the same reason, larger teeth such as molars and canine teeth (cuspid) tend to be darker. The baby's teeth (first teeth) are generally whiter than the adult teeth that follow, again because of the difference in the enamel ratio to dentine.
Maps Tooth discoloration
The effects of aging on dental shadows
Intrinsic color changes tend to accompany aging. Throughout the deposition of secondary dentine life occurs along the internal walls of the pulp chamber. Secondary dentine is darker and more opaque than primary dentine. This gives the dentin a darker overall appearance. At the same time, enamel layers are gradually thinning due to dental wear such as erosion and acid erosion, which are considered normal levels. Enamel also becomes less porous and lacks phosphate.
Cause
Extrinsic color change
Extrinsic coating is common and has many different causes. Same range of factors can taint the surface of the restoration (eg, composite fillings, porcelain crowns). Some extrinsic color changes that are left to stay for a long time can be intrinsic.
- Dental plaque: Although usually barely visible on the surface of teeth, plaque may become tarnished by chromogenic bacteria such as the Actinomyces species .
- Calculus: The neglected plaque eventually hardens, and leads to the formation of hard deposits on the teeth, especially around the gumline. The color of the calculus varies, and can be gray, yellow, black or brown.
- Tobacco: Smoke tar from tobacco products (as well as smokeless tobacco products) tends to form a yellow-brown-black stain around the tooth's neck above the gum line.
- Chew betel.
- Certain foods and drinks. Foods, such as vegetables, rich in carotenoids or xanthonoid can stain teeth. Swallowing colored fluids such as sports drinks, cola, coffee, tea, and red wine can damage teeth.
- Certain topical medications.
- Chlorhexidine (antiseptic mouthwash) binds to tannin, which means that long-term use in people who consume coffee, tea or red wine is associated with extrinsic staining (ie, removable staining) of the teeth.
- Cetylpyridinium chloride, which is found in many antimicrobial mouth rinses, can cause staining because of dead bacterial residues.
- Metallic compounds. Exposure to such metal compounds may be in the form of drugs or other environmental exposures. Examples include iron (black stain), iodine (black), copper (green), nickel (green) and cadmium (yellow-brown).
- Antibiotics. Tetracycline and its derivatives are capable of intrinsic color change (discussed below). However other antibiotics can form insoluble complexes with calcium, iron and other elements that cause extrinsic staining.
Intrinsic color change
The cause of intrinsic color change generally falls into what occurs during dental development and which is obtained later in life. The cause of the known intrinsic dyeing is listed below, but some causes are unknown.
Dental caries
Dental caries (tooth decay) begins as an opaque white spot on the enamel surface. As demineralization progresses, various lesions eventually evolve and the underlying brown color becomes visible.
Fluorosis
Fluorosis can occur when there is chronic and excessive fluoride exposure during the dental development years. Fluoride is a natural mineral in water, although some areas have higher levels than others, and in some areas fluoride is added to the water supply at low levels to help prevent tooth decay. Exposure can also occur through bottled water and fluoride toothpaste. In its mildest form, fluorosis appears as small opaque white spots on the enamel surface. More severe cases exhibit highly hypoplastic enamel enamel, which is also susceptible to surface stain accumulation. Chronologically, fluorescent white fine ribbons can be seen that correspond to high exposure time to fluoride.
Trauma
Dental trauma can cause discoloration. After minor injuries, red discoloration can occur almost instantly. This is due to the breaking of the venous microcirculation to the tooth, while the arteries continue to supply blood to the pulp. The blood then decays gradually and the blue-brown changes develop.
Teeth may turn gray after pulp necrosis due to trauma (pulp death). This color change usually develops weeks or months after injury and is caused by the incorporation of pigment released during the breakdown of pulp and blood tissue into the dentine.
Yellow color changes can occur after pulp canal destruction, ie pulp closure. Trauma in a developing adult tooth (eg, intrusions of baby teeth to bone) may affect the enamel layer of adult teeth. It becomes clear when adult teeth erupt into the mouth.
Pulp necrosis
Teeth die primarily as a result of extensive tooth decay, but this can also occur after tooth trauma or heavy dental drilling during dental preparation before recovery.
Internal choice resort
Internal resorption can sometimes follow tooth trauma (although in other cases it seems unrelated). This is where dentine is absorbed and replaced by a hyperplastic pulp pulp tissue. As this process begins to approach the external surface of the tooth, the pink color of the pulp tissue of this substitute can be seen through the rest of the tooth substance. This appearance is sometimes called "pink teeth from Mummery".
Root canal treatment
Internal staining is common after root canal treatment, but the exact cause for this is not fully understood. Failure to thoroughly clean the necrotic soft tissues of the pulp system can cause staining, and certain root canal materials (eg, gutta percha and cement duct sealer) also can. Another possible factor is the lack of pulp pressure in the dentin tubule after the pulp is removed, causing the incorporation of food stains in dentin.
Amalgam Patch
Amalgam fillings often stain teeth where they are placed. This is most apparent in very old patches, as the pigments slowly emerge from the amalgam filler and the corresponding rusted surface. In addition, metal patches cast a shadow that can be seen through the teeth and make it look darker.
Tetracycline and tetracycline-derivatives
Tetracycline is a broad-spectrum antibiotic, and minocycline derivatives are common in acne treatments. This drug is able to chelate the calcium ions and put into the teeth, cartilage and bone. Ingestion during the dental development years causes a purplish yellow color of dentine, which is visible through enamel and fluorescent under ultraviolet light. Then, the tetracycline oxidizes and the staining becomes brown and no longer fluoresces under UV light. Other drugs derived from tetracyclines such as glycylcycline share these side effects. Because tetracycline crosses the placenta, the child may have dye staining if medication is given during maternal pregnancy.
Genetic disorders
Some genetic disorders affect the development of teeth (odontogenesis), and cause abnormal appearance and tooth structure. Enamel hyperlasia and enamel hypocalcification are examples of damaged enamel that may potentially give a discolored appearance to the teeth. Teeth exposed in this way are also usually more susceptible to further staining obtained throughout life.
Amelogenesis imperfecta is a rare condition that affects enamel formation (amelogenesis). Enamel is brittle, teeth look yellow or brown, and surface stains accumulate faster.
Dentinogenesis imperfecta is a defect of dentine formation, and teeth may turn yellow brown, dark yellow or grayish blue with increased translucency. Dentin dysplasia is another dentin disorder.
Congenital erythropoietic porphyria (Gunther disease) is a rare form of congenital porphyria, and may be associated with discolored red or brown teeth.
Hyperbilirubinemia during the years of tooth formation can make bilirubin combine into tooth-hard tissues, causing yellow-green or blue-green discoloration. One such condition is hemolytic disease in the newborn (erythroblastosis fetalis).
Thalassemia and sickle cell anemia may be associated with discoloration of blue tooth, green or brown.
Most children with cystic fibrosis have teeth that change color. This may be the result of tetracycline exposure during odontogenesis, but the transmembrane regression of cystic fibrosis has also been shown to be involved in enamel formation, suggesting that the disease has some influence on tooth discoloration regardless of tetracycline exposure.
Management
The discoloration of the front teeth is one of the most common reasons people seek dental care. However, many people with normal shade teeth require them to whiten. The management of tooth discoloration depends on the cause. Most color changes are harmless and may or may not be a cosmetic concern for the individual. In other cases it may indicate underlying pathology such as pulp necrosis or infrequent systemic disorders.
Most extrinsic color changes are easily removed by cleaning the teeth, either with "whiten" toothpaste (ie, roughly) at home, or as a professional treatment (eg, scale and/or polishing). To prevent the buildup of extrinsic stains in the future, identification of causes (eg, smoking) is necessary.
Intrinsic color changes generally require one of the many types of teeth whitening. Or the appearance of teeth can be hidden by dental restorations (eg, composite fillings, veneers, crowns).
References
Source of the article : Wikipedia
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